Premium
Does early expansion surgery have a role in the management of congenital subglottic stenosis?
Author(s) -
Rosenfeld Richard M.,
Bluestone Charles D.
Publication year - 1993
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-199303000-00008
Subject(s) - tracheotomy , medicine , subglottic stenosis , subglottis , stenosis , surgery , laryngotracheal stenosis , tracheal stenosis , confidence interval , bronchoscopy , cohort , larynx , airway , radiology , glottis
To better define the clinical course of congenital subglottic stenosis, the authors reviewed a cohort of 27 children managed with long‐term tracheotomy and interval bronchoscopy. Rates of spontaneous resolution were 19% at 6 months, 39% at 12 months, and 69% at 18 months (Kaplan‐Meier survival analysis). Children older than 4 months of age at tracheotomy tended to have more rapid resolution of their stenoses ( P = .08). Overall, the median time to decannulation was 15.8 months (95% confidence interval, 13.9 to 17.6 months). One death was possibly tracheotomy‐related, and 12 (44%) of the children experienced complications or sequelae resulting in new or extended hospitalization. Considering the prolonged cannulation necessary for spontaneous resolution of congenital subglottic stenosis, the role of long‐term tracheotomy as the sole form of management may be limited. Once the need for intervention is apparent, the authors recommend early consideration of cricoid split or laryngotracheoplasty as alternatives to long‐term tracheotomy.